Treatment guidelines for health staff pap smear abnormalities



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TREATMENT GUIDELINES FOR HEALTH STAFF

PAP SMEAR ABNORMALITIES

Pap smear screening is indicated only for students ≥ 21 years of age. Note that the recommendations below apply only to women 21 to 24 years of age. Authorized health and wellness staff may arrange for follow-up of Pap smear abnormalities as follows:




  • Students with a normal Pap smear, with endocervical cells present, should have a Pap smear repeated every three years.




  • Students with a Pap smear demonstrating absent endocervical cells, inadequate cellularity, or obscuring artifact should have a Pap smear repeated in 2-4 months to obtain an adequate specimen.




  • Students with a Pap smear demonstrating inflammation should be evaluated for infection and treated as indicated by the results of testing.




  • Students with a Pap smear demonstrating atypical squamous cells of undetermined significance (ASC-US) should have a Pap smear repeated in 12 months.




  • Students with a Pap smear demonstrating Low-grade Squamous Intraepithelial Lesions (LSIL) should have a Pap smear repeated in 12 months.




  • Students with a Pap smear demonstrating High-grade Squamous Intraepithelial Lesions (HSIL) should be referred for colposcopy.




  • Reflex HPV testing is not indicated in this age group.


WHEN TO REFER TO THE CENTER PHYSICIAN


  • All students in need of colposcopy

  • If the student has questions about her Pap smear abnormalities and the indications for follow-up

  • If the student has questions or anxiety about her colposcopy referral

  • If a student under 21 years of age has HIV infection or an abnormal Pap result from the past


REFERENCE

2012 Updated Consensus Guidelines for the Management of Abnormal Cervical Cancer

Screening Tests and Cancer Precursors

http://www.asccp.org/Guidelines-2/Management-Guidelines-2





July 2015


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